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Long term functional and structural outcomes of laser therapy for retinopathy of prematurity
E McLoone1, M O'Keefe, S McLoone
1The Children's Hospital, Temple Street, Dublin 1, Republic of Ireland.
Insights
Diode laser photocoagulation for threshold retinopathy of prematurity (ROP) offers long-term visual benefits. This treatment helps preserve both distance and near vision in premature infants, with favorable structural outcomes correlating to good visual results.
Area of Science:
- Ophthalmology
- Neonatal Care
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
- Diode laser photocoagulation is a common treatment for threshold ROP.
- Long-term outcomes of this intervention require ongoing assessment.
Purpose of the Study:
- To evaluate the long-term functional and structural results of diode laser photocoagulation for threshold ROP.
- To compare outcomes in treated eyes versus spontaneously regressed ROP.
Main Methods:
- A cohort of 25 patients (43 eyes) treated for threshold ROP with laser were followed for a mean of 11 years.
- A control group of 7 patients (14 eyes) with spontaneously regressed ROP was also examined.
- Comprehensive visual assessments included distance and near acuity, contrast sensitivity, color vision, fundal examination, and autorefraction.
Main Results:
- Laser-treated eyes showed a mean distance visual acuity of 0.37 logMAR and near acuity of 0.39 logMAR.
- Unfavorable distance and near visual acuity outcomes occurred in 13.5% of laser-treated eyes.
- While near acuity, contrast sensitivity, and color vision showed no significant difference compared to controls, distance visual acuity was statistically significantly better in the laser-treated group (p=0.03).
Conclusions:
- Diode laser photocoagulation for threshold ROP demonstrates long-term benefits in preserving distance and near vision.
- Eyes with favorable structural outcomes post-laser treatment generally achieve good visual results.
- The study supports the continued use of laser photocoagulation for threshold ROP to ensure better long-term visual function.
Aims:
To assess the long term functional and structural outcomes of premature babies who received diode laser photocoagulation for threshold retinopathy of prematurity (ROP).
Methods:
25 patients (43 eyes) treated with laser were recalled for assessment at a mean follow up of 11 years. A further seven patients (14 eyes) with subthreshold ROP, which had regressed spontaneously without laser treatment, were also examined. All children underwent distance acuity, near acuity, contrast sensitivity (CS), and colour vision assessments followed by a dilated fundal examination and cycloplegic autorefraction.
Results:
The laser treated eyes had a mean distance visual acuity of 0.37 logMAR, a mean near visual acuity of 0.39 logMAR, a mean contrast sensitivity of 1.49 log CS units, and a mean spherical equivalent of -2.10D. An unfavourable distance visual acuity outcome occurred in five eyes (13.5%). An unfavourable near visual acuity outcome was also noted in the five eyes (13.5%) with poor distance visual outcome. 7% had an unfavourable structural outcome. On comparison with the control group, there was no significant difference in near acuity, CS, refraction, or colour vision between the two groups. However, there was a statistically significant difference in terms of distance visual acuity (p = 0.03).
Conclusions:
Laser treated eyes with favourable structural outcome have a good visual outcome. The results show a long term benefit from diode laser photocoagulation in preserving distance and near vision in eyes with threshold ROP.